Pacemaker on X-ray chest PA view

The pacemaker pulse generator  is seen in the right infraclavicular region, implanted in the subcutaneous plane. There is little bit of sagging of the pulse generator pocket being an elderly subject with loose subcutaneous tissue. The pacemaker lead is seen coursing up into the subclavian vein and hence into the right atrium through the superior vena cava. The tip of the lead is in the right ventricular apex asit is a single chamber (VVI) pacemaker. Additional atrial lead will be seen in case of dual chamber (DDD) pacemaker. A left ventricular lead will be there for biventricular pacemakers used for cardiac resynchronisation therapy.